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Home My WebLink AboutBLDE-21-006140 t,), \ Commonwealth of Official Use Only 111h- t� Massachusetts Permit No. BLDE-21-006140 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/07] APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:4/23/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 400 HIGGINS CROWELL RD Owner or Tenant TOWN OF YARMOUTH Telephone No. Owner's Address 1146 ROUTE 28, SOUTH YARMOUTH, MA 02664-4463 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 50 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Temporary circuit to field for town meeting. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers _ KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiatinc Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: ,Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security. Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Siens Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to start: Inspection to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE:INSURANCE 0 BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Russell E Mealey Licensee: Russell E Mealey Signature LIC.NO.: 14020 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 10 SIGNE RD, DENNIS MA 026382411 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: OWNER'S INSURANCE WAIVER:I am aware that the License does not have the liability insurance coverage normally required by law.But signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $0.00 tC k 4 MaNac a..tts Official Use Only 2 4iit No.C=_:-7-) — 1 4O ri e Occupancy and Fee Checked BOARD OF FIRE PREVF,NTION REGULATIONS [Rev.1/07] am,bi,n ) 3 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK a All work to be performed in accordance with the Manacholetai Electrical Code(MEC).527 CMR 12.00 £ (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 11/2.2.12.1 City or Town of: %c1 vi c 44.1,, To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. d Leeatisn(Street dt Number) 'I C 0 N)11:„,s Cr-,/we.i I F'•rt. Mo•}ra c l p e s v Pi;44Ie S ukoo 1 5 Owner er Tenant t Y SO..r)n 1 b i S+v:c+. Telephone No. Owner's Acura 2'3 6 5++�. -j A') Sn �irran oc �. Is this permit Ir eon ju nubs.with a b�dYg permKZ Yes m No 0 (Check Appropriate Box) l Purpose of Bur 5 1..0 i, i Utility Authorization No. ,� Existing Service Amps / Velfb Overhead 0 Uadgrd 0 Na of Meters s. ,, Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampadty I,eeati a and Nadirs of Proposed Electrical Wort: R u w\ a. SGA i f vv,fLan� C i e-c f;t- ArQ W' i�.y in, •. P4VIC1 to I~ic Ie t=r,v^ 'SPw in Mr , 4./0i1( 4-0 h'e Om"C litRvv SDM JCourpktion of the followiirktle f wbe waived by die&vector of Wises. Total . No.of Recused Landsmen, No.of Cell.-Snsp.(Paddle)Fars Transformers KVA No.of Luminaire Outlets Nag Het Tabs G.aeraten KVA Na of Lamldires Swimming Peel Above ❑ grad. ❑ Ra of Emergency t.lptmg val. Brad. Battery Units Ne.of R.apiade Outlets l No.of OR Burners FIRE ALARMS No.of Zones Detection and F Na of Switches No.of Gas Bnraers Na o Inidatina Devices Total IV Na of Ranges Ne.of Air Coad. Tons No.of Alertlag Device Na of Waste Disposers 'Heat Pump Number Teas KW `Na of Self-Contained Tetab: Detectisa/Aiertm Devices Na of Dishwashers Spare/Area Heating KW Local 0 cea.eet;os 0 Odra Na otDsyers Heating APPS KWNa ofity Devises or Ea dvtdeat No.of Water KW Na of No.of Data Whin:Heaters Sips Ballasts Na of Devices er MNo.Hydrae:usage Bathtubs No.of Meters Total HP Telecommuudcatiens Na of Devices er ' "I OTHER: Attach additional detail ff desired oras required by the hnpector of Wires. Estimated Value of Electrical Work: 5'00.a a (When required by municipal policy.) Work to Start s/2.0 I•.i Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"combed operation"coverage or its substantial equivalent The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE m BOND 0 OTHER 0 (Specify:) I cert'ander the pains and penalties of perjwy,that the information on this gppraaathm is true and complete. FIRM NAME: D y D s.ki. LIC.NO.: Licensee: .N.Ss z./I el ea 1 c Pim f3 7 LIC.NO.:Jt'0 2-0,g (ffaipticabk.enter"camp"in the lie��e number link) Bus.Tel.Ns.: I u Address: 1 l 0 S ili c,H I� w AIt.Tel.Na:7 7'1-3s 3-731 7 'Per M.G.L.c. 147,s_57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally requited by . By my signature below,I hereby waive this requirement. lam the(check one)0 owner Q owner's agent SignatureOwner/Aent Telephone Na (PERMIT FEE:$ 1